Blood test, liver function panel
Facility: Stevens County Hospital
Billing Code: 80076 (CPT)
- CPT Billing Code: 80076
- Insurance Median: $36
- Cash Discount Price: $95
- vs. Medicare Baseline: 4.41x Medicare
Average discount available for prompt cash payment at this facility.
Median negotiated contract rate across all mapped commercial carriers.
Standard federal government reimbursement rate for this code.
Visual Cost Comparison vs. Medicare
Understanding this gauge: We use the federal Medicare rate of $8.17 as the cost baseline. Rates below the baseline represent excellent value. In-network commercial rates commonly hover around 150% - 250% of Medicare, while rates exceeding 300% are elevated. Hover over the green and blue markers to view detailed calculations.
Elevated Commercial Rate Alert (Value-Gap)
The negotiated rate at this facility is 441% of the Medicare baseline (a markup of 341%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.
Out-of-Pocket Cost Estimator
Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.
Commercial Insurance Negotiated Rates
Negotiated contract ranges established by major commercial carriers at this facility.
| Carrier / Plan Group | Contract Rate Range | vs. Medicare Reference |
|---|---|---|
| Aetna | $8 - $95 | 98% |
| Blue Cross Blue Shield | $30 - $32 | 367% |
| Humana | $35 | 428% |
| First Health - All Plans | $86 | 1053% |
| Wppa - All Plans | $90 | 1102% |
| Medicaid / KanCare | $95 | 1163% |
Consumer Guidance & Cost Commentary
For the liver function panel (CPT 80076) at Stevens County Hospital in Hugoton, Kansas, the cash price is $95.00, which matches the facility's maximum negotiated rate with Aetna. While the median negotiated rate across all payers is $36.00, commercial insurance contracts often include administrative overhead that can inflate the baseline price by 20% to 40% compared to direct cash payment. In this specific case, the cash price is identical to the highest negotiated rate, meaning patients with high-deductible plans or those without insurance may save money by paying out-of-pocket directly, provided they secure a "self-pay" or "prompt-pay" discount before scheduling. It is important to verify these discounts with the hospital prior to check-in, as billing systems may default to insurance processing if a card is on file, potentially voiding any cash agreement.
When evaluating the cost relative to federal standards, the Medicare amount for this service is $8.17, which serves as a scientifically validated baseline for the true cost of delivery. The facility's cash price of $95.00 represents a significant markup over the Medicare rate, illustrating how commercial rates can exceed fair pricing benchmarks. Although the data does not provide specific state or county average comparisons for this CPT code, patients should be aware that balance billing is generally prohibited for emergency care and non-emergency services at in-network facilities under the No Surprises Act. To ensure accuracy and avoid unexpected charges, consumers should request a full itemized bill containing specific CPT codes rather than accepting a summary invoice, as over 80% of hospital bills contain errors that can be corrected through a formal written audit